Overview of candidemia in pediatric patients with hematologic and solid organ malignancies.

BACKGROUND AND PURPOSE

Today, with the development of critical patient care and the increase in intravascular invasive methods, the survival rate of patients diagnosed with hematological and solid organ malignancies is increasing, and unfortunately, the incidence of candidemia is also increasing due to multiple risk factors. In this study, we aimed to determine the clinical-demographic characteristics of candidemia and the antifungal susceptibility profile of in pediatric patients with hematological and solid organ malignancies.

MATERIALS AND METHODS

The present study included pediatric patients with hematologic and solid organ malignancies presenting with signs and symptoms consistent with candidemia, in whom was isolated from blood and catheter cultures between January 2010 and August 2023.

RESULTS

Thirty (65.2%) of the patients had hematologic and 16 (34.8%) had solid organ malignancies. In all patients, 23 (50%) had non-catheter-related candidemia and 23 (50%) had catheter-related candidemia. At least one of the risk factors examined was detected in these patients. Catheter-related candidemia was found to be more common in patients diagnosed with hematologic malignancy. The difference was found to be statistically significant (p= 0.030). Drug resistance rates of were 6.5% for amphotericin B, 6.5% for fluconazole, 2.2% for voriconazole and 2.2% for micafungin. No patient with caspofungin resistance was detected. The mean treatment duration of the patients was 21 days (min 3-max 103) and it was observed that amphotericin B and caspofungin were used most frequently in the treatment regimen. The mortality rate of patients with candidemia was 6.5%.

CONCLUSION

Our study showed that patients with hematologic malignancies exhibited a higher susceptibility to catheter-related candidemia compared to patients with solid organ tumors. Caspofungin resistance was not detected in our study, and we believe that each center should know its own antifungal drug sensitivity, determine the treatment regimen accordingly, and that catheters should be removed rapidly in patients with catheter-related candidemia in malignant patients.